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gastrointestinal haemorrhage

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https://www.readbyqxmd.com/read/29723207/benefit-risk-and-cost-of-new-oral-anticoagulants-and-warfarin-in-atrial-fibrillation-a-multicriteria-decision-analysis
#1
Jose Mendoza-Sanchez, Federico Silva, Lady Rangel, Linda Jaramillo, Leidy Mendoza, Jenny Garzon, Andrea Quiroga
INTRODUCTION: Warfarin and new oral anticoagulants are effective in reducing stroke in atrial fibrillation; however, the benefits and risks rates in clinical trials show heterogeneity for each anticoagulant, and is unknown the cost influence on a model considering most of the treatment consequences. We designed a benefit-risk and cost assessment of oral anticoagulants. DESIGN: We followed the roadmap proposed by IMI-PROTECT and the considerations of emerged good practice to perform Multi-Criteria Decision Analysis (MCDA)...
2018: PloS One
https://www.readbyqxmd.com/read/29700095/management-of-decompensated-cirrhosis
#2
Dina Mansour, Stuart McPherson
Decompensated cirrhosis is a common reason for admission to the acute medical unit, and such patients typically have complex medical needs and are at high risk of in-hospital death. It is therefore vital that these patients receive appropriate investigations and management as early as possible in their patient journey. Typical presenting clinical features include jaundice, ascites, hepatic encephalopathy, hepato-renal syndrome or variceal haemorrhage. A careful history, examination and investigations can help identify the precipitating cause (infections, gastrointestinal bleeding, high alcohol intake / alcohol-related hepatitis or drug-induced liver injury), so appropriate treatment can be given...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29619936/intravenous-iron-treatment-in-the-puerperium
#3
Charlotte Holm
Iron deficiency and anaemia in the puerperium are associated with several important clinical consequences, most prominently physical fatigue. Current treatment practice with oral iron supplementation is associated with gastrointestinal side-effects and subsequent poor compliance. Red blood cell transfusion is also widely used to treat severe postpartum anaemia, though accumulating evidence questions its risk-benefit ratio. Intravenous iron has in previous studies been associated with fast improvement of haemoglobin and iron biochemical markers in the treatment of postpartum anaemia, but there is a lack of studies on patient reported outcomes...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29617819/impact-of-valve-type-on-outcomes-after-redo-mitral-valve-replacement-in-patients-aged-50-to-69-years
#4
Naoto Fukunaga, Chisato Miyakoshi, Ryuzo Sakata, Tadaaki Koyama
OBJECTIVES: Little data are available with regard to valve selections in redo valvular surgery. We investigated the impact of valve types on late outcomes after redo mitral valve replacement (MVR). METHODS: We retrospectively reviewed 66 patients aged 50-69 (mean age 62.2 ± 5.1)  years who underwent redo MVR over the past 25 years. In redo MVR, 46 (69.7%) redo procedures were the 1st redo valvular surgeries, 16 (24.2%) were 2nd redos, 3 (4.5%) were 3rd redos and 1 was a 4th (1...
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29610020/pharmacological-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasias-a-position-paper-of-the-italian-society-of-gastroenterology-sige
#5
REVIEW
Gerardo Nardone, Debora Compare, Alberto Martino, Alba Rocco
Angioectasias (AD) belong to benign vascular malformations of the gastrointestinal tract and are responsible for about 4-7% of upper non variceal bleeding, 30-40% of small bowel occult bleeding and 3-40% of colonic bleeding episodes. Gastrointestinal haemorrhage secondary to AD represents an important diagnostic and therapeutic problem that negatively impacts on the quality of life of patients and heath care costs. Endoscopic interventions are the mainstay in both diagnosis and treatment of vascular malformations...
February 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29577257/pharmacogenetics-of-vitamin-k-antagonists-and-bleeding-risk-prediction-in-atrial-fibrillation
#6
María José Serna, José Miguel Rivera-Caravaca, Rocío Gonzalez-Conejero, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Vanessa Roldán, Francisco Marín
BACKGROUND: Polymorphisms in the vitamin K epoxide reductase complex 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) genes increase the bleeding risk in anticoagulated atrial fibrillation (AF) patients. Here, we aimed to investigate whether VKORC1 and CYP2C9 polymorphisms improved the predictive performance for major bleeding using the HAS-BLED score. MATERIAL AND METHODS: We recruited 652 consecutive AF patients stable on vitamin K antagonist (INR 2.0-3.0) during at least the previous 6 months...
March 25, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29564837/prothrombin-complex-concentrate-for-major-bleeding-on-factor-xa-inhibitors-a-prospective-cohort-study
#7
Sam Schulman, Peter L Gross, Bruce Ritchie, Susan Nahirniak, Yulia Lin, Lani Lieberman, Marc Carrier, Mark A Crowther, Indy Ghosh, Alejandro Lazo-Langner, Michelle Zondag
Oral factor Xa inhibitors are increasingly used for anticoagulation, but there is no approved reversal agent. Prothrombin complex concentrate (PCC) for the management of Xa-inhibitor-associated bleeding has been described in small case series and one cohort study. Patients on apixaban or rivaroxaban, suffering a major bleed, were treated at nine Canadian hospitals as per existing hospital protocol with a fixed dose of PCC 2,000 units and subsequently recruited for a 30-day follow-up. The treating physician evaluated the haemostatic effectiveness as observed during the first day as good, moderate or poor/none, using an assessment guide...
March 21, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29557269/acute-diffuse-alveolar-haemorrhage-accompanied-by-gastrointestinal-bleeding-in-a-patient-with-serious-systemic-lupus-erythematosus-a-case-report
#8
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29556685/mortality-among-patients-due-to-adverse-drug-reactions-that-lead-to-hospitalization-a-meta-analysis
#9
Tejas K Patel, Parvati B Patel
PURPOSE: The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADRAd ), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADRAd . METHODS: We identified prospective ADRAd -related studies via screening of the PubMed and Google Scholar databases with appropriate key terms...
March 19, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29549202/can-virtual-autopsy-with-postmortem-ct-improve-clinical-diagnosis-of-cause-of-death-a-retrospective-observational-cohort-study-in-a-dutch-tertiary-referral-centre
#10
Lianne J P Sonnemans, Bela Kubat, Mathias Prokop, Willemijn M Klein
OBJECTIVE: To investigate whether virtual autopsy with postmortem CT (PMCT) improves clinical diagnosis of the immediate cause of death. DESIGN: Retrospective observational cohort study. INCLUSION CRITERIA: inhospital and out-of-hospital deaths over the age of 1 year in whom virtual autopsy with PMCT and conventional autopsy were performed. EXCLUSION CRITERIA: forensic cases, postmortal organ donors and cases with incomplete scanning procedures...
March 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29479680/laparoscopic-ovariectomy-in-eastern-grey-kangaroos-macropus-giganteus-and-red-kangaroos-macropus-rufus
#11
S A Colgan, L A Green
OBJECTIVE: To develop a technique for permanent sterilisation of female eastern grey kangaroos (Macropus giganteus) and red kangaroos (M. rufus) as part of a large-scale macropod management program on an enclosed 1545-ha site in western Sydney. METHODS: Free-ranging female kangaroos (n = 1409: 1285 eastern grey kangaroos, 124 red kangaroos) were anaesthetised via remote anaesthetic drug delivery of tiletamine/zolazepam, medetomidine and acepromazine prior to inhalational anaesthesia using isoflurane-oxygen...
March 2018: Australian Veterinary Journal
https://www.readbyqxmd.com/read/29472423/dieulafoy-s-lesion-of-the-duodenum-a-comparative-review-of-37-cases
#12
Faisal Inayat, Waseem Amjad, Qulsoom Hussain, Abu Hurairah
Dieulafoy's lesion is an abnormally large, tortuous, submucosal vessel that erodes the overlying epithelium without primary ulceration or erosion. The lesion predominantly occurs in the proximal stomach but it is also reported in extragastric sites. The pathogenesis and precipitating factors are poorly understood. Patients frequently present with gastrointestinal haemorrhage that can range from being self-limited to massive life threatening. Although there are no standard guidelines, endoscopy has significantly impacted the diagnosis and management...
February 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29446520/lenalidomide-as-a-novel-therapy-for-gastrointestinal-angiodysplasia-in-von-willebrand-disease
#13
N V Khatri, B Patel, D R Kohli, S S Solomon, K Bull-Henry, C M Kessler
INTRODUCTION: Lenalidomide is a thalidomide analog with anti-angiogenic properties. Previous case reports suggest its efficacy in preventing gastrointestinal bleeding (GIB) secondary to angiodysplasia (AD) in hereditary haemorrhagic telangiectasia and potentially in reversing AD. We present the first case series to explore lenalidomide as a treatment for AD-related GIB in patients with von Willebrand disease (VWD). METHODS: A retrospective chart review was conducted to include patients with VWD, who were evaluated from 2010 to 2013 and who had received lenalidomide to treat recurrent GIB secondary to AD...
March 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29444881/ischaemic-stroke-haemorrhage-and-mortality-in-older-patients-with-chronic-kidney-disease-newly-started-on-anticoagulation-for-atrial-fibrillation-a-population-based-study-from-uk-primary-care
#14
MULTICENTER STUDY
Shankar Kumar, Simon de Lusignan, Andrew McGovern, Ana Correa, Mariya Hriskova, Piers Gatenby, Simon Jones, David Goldsmith, A John Camm
OBJECTIVE: To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrial fibrillation and chronic kidney disease. DESIGN: Propensity matched, population based, retrospective cohort analysis from January 2006 through December 2016. SETTING: The Royal College of General Practitioners Research and Surveillance Centre database population of almost 2...
February 14, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29426403/putative-virulence-factors-and-clonal-relationship-of-o174-shiga-toxin-producing-escherichia-coli-isolated-from-human-food-and-animal-sources
#15
Cecilia Cundon, Claudia Carolina Carbonari, Gisela Zolezzi, Marta Rivas, Adriana Bentancor
Shiga toxin-producing Escherichia coli (STEC) is th etiological agent of gastrointestinal diseases as haemorrhagic colitis and haemolytic-uraemic syndrome (HUS). Shiga toxin (Stx) is the main virulence factor. There are two types, Stx1 and Stx2, and several subtypes. Other virulence factors are involved in pathogenesis. While O157:H7 is the predominant serotype, at present non-O157 STEC strains are increasingly recognized as foodborne pathogens worldwide. In Argentina, STEC O174 stands out as an emerging pathogen and is one of the four most prevalent non-O157 STEC serogroups...
February 2018: Veterinary Microbiology
https://www.readbyqxmd.com/read/29384479/susceptibility-of-eastern-water-dragons-intellagama-lesueurii-lesueurii-to-bohle-iridovirus
#16
A Maclaine, N Mashkour, J Scott, E Ariel
Ranaviruses infect and have been associated with mass mortality events in fish, amphibians and reptiles and are capable of interclass transmission. Eastern water dragons (EWDs), a semi-aquatic squamate, have an overlapping distribution with several species shown to be susceptible to Bohle iridovirus (BIV). However, this species has not been previously investigated, and no known mass mortalities have occurred in wild populations. Here we report the experimental infection of juvenile EWDs with BIV to investigate a water-dwelling lizards' susceptibility to a ranaviral strain present in northern Queensland, Australia...
January 31, 2018: Diseases of Aquatic Organisms
https://www.readbyqxmd.com/read/29372068/congenital-absence-of-the-portal-vein-in-a-cat
#17
Andrew Holloway, Louise Groot, Klaartje van der Schaaf
Case summary: A 9-month-old female neutered domestic shorthair cat presented with a history of episodic ptyalism, lethargy and abnormal behaviour. The clinical signs together with elevated pre- and post-prandial bile acid concentrations were consistent with hepatic encephalopathy (HE). In the absence of a portosystemic shunt (PSS) on abdominal ultrasound, medical management of HE was established with a protein-restricted diet and lactulose and the neurological signs resolved. Following an episode of acute vomiting and haemorrhagic diarrhoea at 19 months of age abdominal ultrasonography was repeated...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29371325/a-three-year-prospective-study-of-the-presentation-and-clinical-outcomes-of-major-bleeding-episodes-associated-with-oral-anticoagulant-use-in-the-uk-orange-study
#18
Laura Green, Joachim Tan, Joan K Morris, Raza Alikhan, Nicola Curry, Tamara Everington, Rhona Maclean, Khalid Saja, Simon Stanworth, Campbell Tait, Peter MacCallum
The outcomes of patients developing major bleeding while on oral anticoagulants remain largely unquantified. The objectives of this study were to: (i) describe the burden of major hemorrhage associated with all available oral anticoagulants in terms of proportion of bleeds which are intracranial hemorrhages, in-hospital mortality and duration of hospitalization following major bleeding; (ii) identify risk factors for mortality; and (iii) compare the characteristics of major hemorrhage between cases treated with warfarin and direct oral anticoagulants for the subgroups of patients with atrial fibrillation or venous thromboembolism...
April 2018: Haematologica
https://www.readbyqxmd.com/read/29337134/acetylcholine-receptor-antibody-titers-and-clinical-course-after-influenza-vaccination-in-patients-with-myasthenia-gravis-a-double-blind-randomized-controlled-trial-propatient-trial
#19
Björn Tackenberg, Maximilian Schneider, Franz Blaes, Christian Eienbröker, Carmen Schade-Brittinger, Anne Wellek, Marcus Deschauer, Markus Eickmann, Hans-Dieter Klenk, Hans-Helge Müller, Norbert Sommer
BACKGROUND: It is a continuous matter of discussion whether immune activation by vaccination in general and Influenza vaccination in particular increases the risk for clinical deterioration of autoimmune diseases. This prospective study investigated the serological and clinical course of autoimmune Myasthenia gravis (MG) after a seasonal influenza vaccination. METHODS: This randomized, placebo-controlled, double-blind study enrolled MG patients with antibodies against acetylcholine-receptors (AChR-ab)...
February 2018: EBioMedicine
https://www.readbyqxmd.com/read/29313587/hereditary-haemorrhagic-telangiectasia-with-severe-anemia-and-recurrent-cns-infections
#20
Nrushen Peesapati, Pbpr Naidu, S Sunitha, P V Sivaram
Hereditary Haemorrhagic Telangiectasia, also known as Osler-Rendu-Weber disease is a rare autosomal dominant disorder affecting small vessels of multiple systems whose main pathological change is the presence of abnormal arteriovenous communications. Usually presents as skin and mucosal telangiectasias, epistaxis, gastrointestinal bleeding and visceral arteriovenous malformations. Although the epistaxis and gastrointestinal blood loss can result in anaemia, patients with hereditary haemorrhagic telangiectasia rarely presents as severe anaemia1 or CNS infections...
September 2017: Journal of the Association of Physicians of India
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